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Individual

MR. MICHAEL JOHN CARLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MSSW LICSW

Contact information

Practice address
9075 QUADAY AVE NE, SUITE 102, OTSEGO, MN 55330-6672
(763) 746-9492
(763) 746-3685
Mailing address
1900 SILVER LAKE RD NW, SUITE 110, NEW BRIGHTON, MN 55112-1786
(651) 628-9566
(651) 628-0411

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
7229
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
536557100
MN
Enumeration date
07/10/2006
Last updated
06/17/2008
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